الصداع ما بعد الصدمة: ماذا تفعل عندما لا يُجدي العلاج بالمكملات الطبيعية نفعًا

References

Prescription preventive therapies (e.g., amitriptyline, topiramate, or propranolol) should be chosen on a case-by-case basis considering side-effects and headache phenotype, starting 4–6 weeks post-injury if headaches are not improving and are occurring more than 1–2 days/week, impact function, or both.

Additional therapies including onabotulinumtoxinA and CGRP-targeted therapies do not have direct evidence in children with PTH but based on experience of our group may be considered in youth with refractory PPTH.

Non-pharmacologic interventions including cervico-vestibular therapy and behavioral interventions, such as CBT, should be considered in PTH management based on clinical assessment.

Assessed HA outcomes when amitriptyline was started 1-month post-injury and continued for median of 4 months; 82% reported >50% reduction in number of HA days and side-effects (primarily sedation) were reported in 33%.